This article explains, among other things:
- What gout is and how it occurs
- Which foods are allowed and forbidden
- Why beer is a particularly sensitive issue with gout
- How to lower uric acid immediately
We start with the definition to have the same basic understanding of gout and the causes...
What is gout and what does diet have to do with it?
Gout describes a disorder of the purine metabolism, as a result of which uric acid crystals form in the joints and tissue. A doctor can determine whether the uric acid level is too high and whether there is a risk of gout via the blood count.
Men over the age of 40 are particularly frequently affected, which is due to the combination of beer and meat that is predominantly found in men.2
Women, on the other hand, are less likely to develop gout and if they do, it tends to be at an older age.[<[sup>3
There are basically two different symptoms by which the disease manifests itself:
- Acute gout attacks
In addition to sudden severe pain, an acute attack of gout is also characterised by swelling of the affected joints and fever - which is triggered by the inflammation in the joints.[<[sup>4
In rare cases, headaches and vomiting may also occur. If the acute attack of gout is not treated with medication, it can take one to two weeks for the swelling to subside. - Chronic gout
After the first acute attacks, gout becomes chronic. The joints are destroyed over the long term and without much pain. This can be recognised by an X-ray. In addition to the deformation of the joints, uric acid crystals are also deposited in the kidneys, which can lead to kidney stones and, in the worst case, kidney failure.
As gout is often the result of a poor and unbalanced diet, it falls into the category of "diseases of affluence". Like most diseases of affluence, gout can be brought under control to a certain extent in the long term with the right diet.5
However, gout is largely genetic, which unfortunately cannot be influenced.[<[sup>6
A study from 2017 shows that losing excess weight is beneficial for lowering uric acid levels and thus reducing the risk of gout.7
Gout can be prevented through an appropriate diet. However, if you already have the disease, it can no longer be cured. In this case, the progression can be mitigated by a low-purine diet and the disease brought under control.
To understand how gout and diet are linked, we clarify the connection between the three crucial elements.
The connection between gout, purines and uric acid
The cause of gout is so-called hyperuricaemia, which stands for an excessively high uric acid level in the blood. Excessive uric acid levels are in turn caused by a diet high in purines.
Purines: What they do in the body
Purines8 are organic compounds that occur in the human body as well as in drinks and food. Like pyrimidines, they are building blocks of nucleic acid and therefore a basic building block of all DNA.
Purines in the form of adenine and guanine are an integral part of every human cell and are used to build DNA.
The purines contained in food and drinks are converted to uric acid in the body after ingestion.
Intake of more than 500 mg of uric acid (approx. 450 g of chicken breast) per day should be avoided in order not to increase the risk of gout.[<[sup>9
Uric acid - degradation product of purine metabolism
Uric acid is formed at the end of purine metabolism as a degradation product of purine bases. Uric acid forms crystals, which are white and odourless. If too many of these crystals form in the joints and tissues, the aforementioned disease gout occurs.
A diet rich in purines leads to an increased uric acid level, which in turn greatly increases the risk of gout.
If the uric acid level is too high, this is referred to as hyperuricaemia. This is reached as soon as the uric acid level in the blood exceeds the limit of 7.4 mg/dl in men and 6.7 mg/dl in women.
Above this limit, the uric acid crystals can no longer be dissolved naturally in the body and they begin to form unhindered.
Doctors prescribe medication with allopurinol, benzbromarone and febuxostat if the uric acid level in the blood is too high.
These foods are prohibited with gout
- Indigenous products (e.g. sweetbreads, liver, kidneys)
- Trout
- Sprotte
- Canned fish (e.g. oil sardines)
- Seafood (e.g. shrimps)
- Beer
- Sugary drinks (e.g. cola)
- Peanuts
The list of prohibited foods shows those foods that are listed in each table of purine-containing foods (purine table).
The forbidden list shows the foods that rank at the top of every table of purine-containing foods (purine table) that can be found on authoritative websites such as the ÖGK. The higher up a food is on the list, the more likely it is to be avoided. The purine content is too high for people who suffer from gout.
Foods with a purine or uric acid content of more than 300 mg per 100 g should be avoided in particular.10
Vegetables rich in purines are also often included in lists of forbidden foods for gout. However, a 12-year study has shown that consuming moderate amounts of vegetables with a high purine content does not lead to an increased risk of gout.11
Black tea or coffee can also be drunk with a clear conscience.
Drinks table for gout sufferers
The table below lists various drinks and how dangerous their consumption is for gout:
Drink: Consumption
Beer (also non-alcoholic): very questionable
High-proof alcohol: very questionable
Sugary soft drinks: questionable
Sweetened fruit juices: questionable
Freshly squeezed juices: harmless
Milk: harmless
Coffee: desirable
Tea: desirable
Water: desirable
In general, you should drink still water, preferably with a dash of lemon juice (because of the vitamin C it contains), or tea, as plenty of water helps to dissolve uric acid better. Sugary soft drinks should be avoided if possible.12
The purines contained in foods and drinks are converted to uric acid in the body after ingestion.
Smoothies containing vegetables such as carrots or spinach are also very suitable. These contain very little fructose, but lots of valuable nutrients and vitamins.
Fructose and nutrition for gout
Fructose is nothing more than the fructose contained in fruit. As fructose is contained in pineapples, bananas and other fruits, it is not a problem because the concentration is far too low.
The problem arises when foods with industrially isolated fructose are consumed.13 This artificial form of fructose is often used in processed food and ready meals because it is the most economically profitable for companies.
Apart from the fact that this increased intake of isolated fructose drives up insulin levels - which increases the risk of diabetes - the consumption of fructose also causes the body to produce purines.
If you have to watch your diet due to gout, you should avoid foods with added fructose as much as possible.
Beer and gout don't mix!
Beer is a double vice when it comes to gout. On the one hand, brewer's yeast contains too many purines, which drastically increases the uric acid level in the blood. On the other hand, the alcohol it contains prevents the body from breaking down uric acid optimally.
In the summer months at barbecues, beer is often consumed together with meat and sausages, which is doubly bad for gout patients.
In contrast to beer, the moderate consumption of wine is not a problem, as a study from 2004 found.14 However, it is not yet clear exactly which components in wine are harmless to uric acid levels.
Are chocolate and bananas okay for gout?
Don't worry, you don't have to give up chocolate if you have gout or are at increased risk.
Neither in the form of a bar nor as drinking chocolate is there anything to worry about. With chocolate, the added sugar is more of a problem if it is consumed in excessive quantities.
Bananas are a safe food with a purine content of just 11 mg per 100 g. Their vitamin C content also ensures that the risk of gout is minimised. Their vitamin C content also ensures that uric acid is reduced - more on this shortly.
Which foods should you definitely eat if you have gout?
Several cups of coffee a day and vitamin C-containing vegetables (e.g. peppers) can lower uric acid levels in the blood.[<[sup>15
A long-term study with over 45,000 participants suggests that more than 4 cups of coffee per day keeps the risk of gout low.16 It does not matter whether it is caffeinated or decaffeinated coffee. Researchers assume that the chlorogenic acid contained in coffee counteracts uric acid.
In general, with the exception of offal and the foods mentioned above, nothing needs to be completely avoided. Pulses and asparagus are also often in the firing line of many critics. However, it is actually only the dose or the combination with other purine-rich foods that has an unfavourable effect on uric acid in the blood.
A plate of lentils would still be okay as long as it is not consumed together with a lot of sausage and a beer.
Lower uric acid naturally and herbal with vitamin C
High consumption of vitamin C has been shown to reduce the risk of developing gout.17
Luckily, vitamin C is found naturally in many varieties of herbs, vegetables, leafy greens and fruit. The following table lists foods with an outstanding vitamin C content:
Food: Vitamin C content per 100 g
Acerola: 1790 mg
Seabuckthorn: 450 mg
Rosehip: 426 mg
Burnet: 330 mg
Blackcurrants: 189 mg
Parsley: 159 mg
Wild garlic: 150 mg
Peppers: 140 mg
Broccoli: 115 mg
Rosy sprouts: 110 mg
Kiwi: 100 mg
Lemons: 53 mg
In a study conducted over 20 years, fewer people who consumed more than 1,500 mg of vitamin C per day developed gout than those who consumed less than 500 mg per day.
Cherries against gout
Cherries help against gout. This is proven by a study in which 633 people suffering from gout were followed for a year.19
The people who ate cherries over a period of 2 days had a 35% lower risk of a gout attack - compared to those who did not consume cherries.
Another study investigated these results further and also found a positive correlation between the consumption of tart cherry juice and a reduction in uric acid levels in the blood.20
The DASH diet helps against gout
The DASH diet is often mentioned in combination with gout. DASH stands for "Dietary Approaches to Stop Hypertension". A diet that aims to sustainably reduce high blood pressure.
The reason why this form of nutrition - the DASH diet has less to do with classic diets - helps against gout is that it focuses primarily on fruit and vegetables. It is precisely those foods that do not raise uric acid levels too much.
The DASH diet is a huge topic in itself, which is beyond the scope of this article.
High-calorie diet: an option for gout?
While a low-purine diet is crucial for controlling the symptoms of gout, there are situations in which patients may also need a high-calorie diet. High-calorie nutrition is particularly useful for people who are underweight or need extra calories to meet their energy needs without having to consume large amounts of food.
However, when choosing liquid food, it is important to choose foods that are rich in healthy fats, complex carbohydrates and high-quality proteins, but remain low in purines.
High-calorie diets such as Saturo's astronaut food can offer an ideal solution here. Saturo's specially developed drinks not only provide a high calorie count, but are also designed to provide the body with a comprehensive supply of all essential nutrients - from proteins and carbohydrates to lipids and fibre, as well as a full spectrum of vitamins and minerals. This makes them a practical option for anyone who wants to supplement their diet without unnecessarily increasing their purine levels.
Conclusion on the right diet for gout
The three elements - gout, purines and uric acid - are inextricably linked. It is impossible to prevent and manage the disease without dealing with purines and your own uric acid levels.
While it is not necessary to completely avoid meat, a plant-based diet should be preferred in order to minimise the risk as far as possible, as even high-quality meat (such as fillet) contains too many purines.
Those who focus on a low-purine diet and a predominantly meat-free diet in the long term will sustainably reduce the risk of developing gout and even suffering kidney failure as a result.
Not sure if you can do all this properly in your stressful everyday life?
With a wholesome, balanced and low-purine diet, uric acid levels remain in the green range in the long term and the joints are protected from swelling.
The most important information at a glance:
- Gout is a metabolic disease that leads to inflammation and deformation of the joints.1
- A diet high in uric acid leads to increased uric acid levels, which in turn greatly increases the risk of gout.
- A distinction is made between acute attacks of gout and chronic gout.
- The amount of 500 mg of uric acid (approx. 450 g of chicken breast) per day should not be exceeded.
- Giblets should be avoided at all costs with gout, especially sweetbreads.
- A lot of vitamin C helps with too much uric acid in the blood.
FAQ: Nutrition for gout
Which home remedy helps against gout?
Coffee (caffeinated or decaffeinated) and plenty of vitamin C help to reduce the risk of gout in the long term. Cool compresses help to relieve the pain and swelling of an acute attack of gout.
How long does swelling last with gout?
If the gout attack is not treated with medication, it usually takes between one and two weeks for the painful swelling to subside.21
How does gout manifest itself?
An attack of gout is characterised by inflammation and overheating of the joint, which usually reach their peak within a few hours. Chronic gout gradually leads to deformation of the joints, which is particularly noticeable in the fingers and toes.
Which foods should I avoid if I have gout?
If you have gout or are at high risk, you should urgently avoid offal (e.g. sweetbreads) and seafood. Alcoholic drinks should only be consumed rarely and with extreme caution. One glass of wine a day, for example, is not a danger.
How much uric acid is allowed per day?
Normally, it is sufficient to stay below a daily amount of 500 mg uric acid (approx. 450 g chicken breast). If you want to be on the safe side or are already struggling with gout, it is better to stay below 300 mg uric acid per day.
Which foods contain the most purines?
Offal such as sweetbreads and kidneys contain by far the most purines. However, seafood and certain fish (e.g. sprats) are also extremely high in purines.
How high can uric acid in the blood be?
The uric acid level in the blood should not exceed the limit of 7.4 mg/dl for men and 6.7 mg/dl for women. If it is higher than this, it is referred to as hyperuricaemia.
Which medications lower uric acid?
Medications with allopurinol, benzbromarone and febuxostat are mainly used for hyperuricaemia.
How do you get rid of gout?
In order to get gout under control in the long term, a change in diet is particularly important: avoid purine-rich foods such as offal, meat extracts, pulses and alcohol, which increase uric acid levels in the blood. Instead, you should drink plenty of water and favour alkaline foods such as fruit and vegetables to flush out uric acid and deacidify the body. Regular exercise and stress reduction can also help to prevent gout attacks and alleviate the symptoms.
You might also be interested in this
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